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Permit CITY OF TIGARD ELECTRICAL PERMIT 111 DEVELOPMENT Permit #: ELC2012 -00293 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/21/2012 Parcel: 2S 111 ACO2700 Jurisdiction: Tigard Site address: 14650 SW 97TH AVE Project: Twality Middle School Subdivision: PINEBROOK TERRACE Lot: 67 Project Description: 1 ck + 5 additional for Twality, Science room upgrade Contractor: PARKIN ELECTRIC INC Owner: UNION HIGH SCHOOL DISTRICT 14001 FIR STREET NO. 3 JT OREGON CITY, OR 97045 00000 PHONE: 503 - 657 -4958 PHONE: FAX: 503 - 557 -1059 FEES Quantity Description Date Amount 6 crt Branch Circuits wo /Purchase 05/21/2012 $93.28 Specifics: Service or Feeder 1 ea 12% State Surcharge - 05/21/2012 $11.19 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $104.47 Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Ore on law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through OA 2 -001 -0 0. You may twin a copy f the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. 4 0.332.2344. Issued By: Permittee Signature: e 4 PPL I fnO + OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease or rent. OWNER'S SIGNATURE Date: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC' Date: LICENSE NO. Call 503.639.4175 by 7:00 a.m. for the next available Inspection date. This permit card shall be kept In a conspicuous place on the job site until completion of the project. Approved plans are required on the Job site at the time of each Inspection. From: 05/17/2012 15:23 #414 P.002/002 5 ' RECEIVED 04---- Electrical Permit Application FOR OFFICE USE ONLY City of Tigard MAY 17 2012 Received Permit No. &LA am A MM II • 13125 SW Hall Blvd., Tigard, OR 97223.. Plan Review C - Phone: 503.718.2439 Fax: 503.598.]b&V OF rI AF D natcB : Other Permit T I G A It D Inspection Line: 503.639.4175 ] 1 ' 4 i1` /''N �'"t i s ' , p 7rA l[ i Date Ready/By: ® See Page 2 for Internet: www.tigard- or.gov � •y' 1 a:y• Notified/Method: NM Supplemental Information - -ter ,., , �'•S+ . _ - �- -, . �. ,. ...a _. .._�''� ..:, �u. v�.;; �cx :`•_.- .3:��:�.i..,sn�:4r.'; a;f;;: .. .:a_'�i. ry >�.s��. £.r - ."a, _:.,��,�a •,.,.;. , -s . .. .. ❑ New const ruction Addition /alteration/replacement `' Please check a11 that apply (submit 2 sets of plans w/items checked below): ❑ Service or feeder 400 amps or more ❑ Building over three stories. where the available fault current ❑ Marinas and boatyard ❑ Demolition ❑Other; eM.x r.;. Other; ,,..., boatyards. Rrak r , `` ; , i . ;, 3, _. ,. s; ,.• _ , %1 , ex ceeds 10 000 amps 150 volts or Floating b uil dings. a..� :; - � r `�� qa�� -'��' Y.�"". _��k ❑ d. ; . 2.= -' >e ..x .' -<Ka ;? .a,�� Qs... "r ate; a w S • ' less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ❑ 1- and 2- family dwelling E'Commercial/industrial ❑ Accessory building amps for all other installation buildings. ❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or f x „ , : F; , Y , , c a ,., �., . - . i , i i $ - z , ; , .., . Y , _ ;,; ❑ Emergency system- larger separately derived system. .f . ` +...a_.,:?� $ ,. 19 }. r' O ii fl,. - 0, , A,., ‘,'s , .:1j ,5 ❑ Addition ofnew motor load of ❑ " " 2 ... 1 -3 ,. • Job no.: I Job site address: 1 L165) S q 7.4."C 100HP or more. occupancy. ❑Six or more residential units. ❑ Recreational vehicle parks. City /State/ZIP: 7 o 9 ;' r� e y ❑ Health -care facilities. ❑ Supply voltage for more than ` ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: 13 Service or feeder 600 amps or more. Cross street/directions to job site: sa �� � natWpli6o I Qty. I Fm I � iatal z d l < • New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: I Lot no.: 1,000 sq. ft. or less 168.54 4 Tax map /parcel no.: Ea. add'I 500 sq. ft. or portion 33.92 1 Limited energy, residential r;. mss; = > ".. , 75.00 2 = ' .`` N' i ;9_- nt tali :-' with above . ft. �BSCltIF1I0u:�OF WORK,` ;: i =:::. ; ; ; ;,�,�,.:. �: > 5 ' GK .� Limited energy, multi - family 75.00 2 Mgr jOr-,2 4r TWa- /, i residential (with above sq. ft.) / - ,, S or feeders installation alteration, and/or relocation rr 't g y - (.Q On e r e _ N. j 200 amps or less 100.70 2 U tz" ft �.a, s° r, � P#OPER�"!t' <b�VJ�ER�.= ���:,� �� •yF' � _ -.. �t��. `TB�j,4�PI' �`> *'`�;.�'� :. a,'. ;s_ 201 amps to 400 amps 133.56 2 ..... -., �.'C - hi -- '.4`.Yir, �<�': v -.- .. ., _... ii i^ ' ,:i.rVl Name: 1 �' � / a S r I n 401 amps to 600 amps 200.34 2 L �z f lXlf -GP ,P��fg� 601 amps to 1,000 amps 301.04 2 Address: pi c Q 5 q 71 A.C. Over 1.000 amps or volts 552.26 _ 2 TrgareQ , ©R 9 `7 / r 7 ' � relocation services or feeders Installation, alteration, and/or City/State/ZIP: Phone: ( ) Fax: ( ) 200 amps or less 59.36 I 201 amps to 400 amps 125.08 2 Owner installation: This installation is being made on property that 1 own which is not 401 599 amps [05 amps 168.5 4 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch t o 599 - new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with , v . N _. x:� ;; iz �:, 5, -y.; �v/� above service or feeder fee, .- ._' : ;,.� �:���� ti I e :_1�1 :YCl� '2` ^,i', .. ,.'r;`.:_ - } ?4-;r .1.- `�^(►:V �� - , , iE "f;3: ... •.... .. t . ..,.:.. _....,. , c� :..,,',- �.i2::�i._.,. ; �i� .v : ,,. ,_ _ _ ..r .. - ._. _�.....� P$!!t501V:.� - ±. � .,7 ✓, �. 7.42 2 �:r,. - each branch circuit Business name: B. Fee for branch circuits without service or feeder fee, first @ 56.18 56• /8 2 Contact name: branch circuit Address: Each add' I branch circuit £j 7.42 37, /r) 2 Miscellaneous (service or feeder not included) City /State/ZIP: Each manufactured or modular 67.84 2 dwelling, service and/or feeder Phone: ( ) Fax: : ( ) Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 E - mail: Sign or outline lighting 67.84 2 `, . , :: <i:'hr'.z,CO)VTINGT,OJI , '• :;: , ' .... gia Signal • ctrcuit(s) or limited energy Business name: Parkin Electric panel, alteration, or extension. Page 2 _ 2 Each additional inspection over allowable In any of the above Address: 14001 Fir Street Additional inspection (1 hr min) 66.25/ hr City /State/ZIP: Oregon City, OR 97045 Investigation (1 hr min) 66.25/ hr Industrial plant (1 hr min) 78.18/ hr Phone: (503) 657 - 4958 I Fax: (503) 1059 Inspections for which no fee is 90 r 1CCB Lic.: 35151 ��� llr' t 1 specifically listed Oh hr min) — 1 .1 �l/r lectricat Lic.: 34-4C -All( Lic.: 4241 -5 LOX` Y ;� ; ;;•r:��`,�; - cAL }P6It11'fiTF�;ES`� ':� �� ; ;: ;' Va Subtotal: 9 ?. tJ Suprv. Electrician signature, required: , Plan review (25% of permit fee): Print name: David B Parkin Date: State surcharge (12% of permit fee): 1 j , / 9 TOTAL PERM rr FEE: r 0 f 9 7✓ Authorized signature: This permit application expires If a permit Is not obtained within 180 days after It has been accepted as complete. Print name: Date: * Number of inspections allowed per permit. i:\ BuildingtPermhstELC- PennitApp.doc 07/01 /IO 440- 4615T(11/05/COM/WEB